seva school, coventry, west midlands admission form name:-...

SEVA School, Coventry, West Midlands

ADMISSION FORM

Name:- ____________________________________________________

SEVA School

Eden Road, Walsgrave, Coventry, CV2 2TB

Telephone:- 02477 987619

www.sevakeducationtrust.org

http://www.sevakeducationtrust.org/

PLEASE FILL IN ALL THE FOLLOWING DETAILS USING BLOCK CAPITALS

1. STUDENT’S LEGAL FORENAME……………………………………………………………….

2. MIDDLE NAMES ……………………………………………………………………………………..

3. STUDENT’S LEGAL SURNAME…………………………………………………………………

4. STUDENT’S PREFERRED NAME………………………………………………………………

5. DATE OF BIRTH ………………………………………………………………………………………

6. GENDER …………………………………………………………………………………………………

7. ADDRESS ……………………………………………………………………………………………….

...…………………………………………………………………………………………………………….

8. PREVIOUS SCHOOL AND ADDRESS ……………………………………………………….

…………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………

Student Details

This section asks for details of parents and others with legal status as parents/carers.

Parents/Carers at home – Please give details of all with parental responsibility where

the student lives. Full names and date of birth required for attendance letters.

MR □ MRS □ MISS □ MS □ OTHER □ Please Specify

FULL NAME …………………………………………………………………………………………………….

RELATIONSHIP ……………………………..………………………. DOB ……………………………….

ADDRESS ……………………………………………………………….. POSTCODE ……………………

MOBILE PHONE No …………………………… HOME PHONE ……………………………………

EMAIL ADDRESS ……………………………………………………………………………………………..

WORK PLACE/ADDRESS …………………………………………………PHONE …………………….

OCCUPATION ………………………………………………………………………………………………….

Parents/Carers at home – Please give details of all with parental responsibility where

the student lives. Full names and date of birth required for attendance letters.


FULL NAME …………………………………………………………………………………………………….




EMAIL ADDRESS ……………………………………………………………………………………………..

WORK PLACE/ADDRESS …………………………………………………………………………………

PHONE ……………………………………………………………………………………………………………

OCCUPATION ………………………………………………………………………………………………….

Parental Responsibility 1

Parental Responsibility 2

Others with parental responsibility if address is different to student – please give

details of anyone else with parental responsibility who lives elsewhere. All parents are entitled to information about their children’s progress at school and we have a

duty to pass this on.


FULL NAME …………………………………………………………………………………………………….




EMAIL ADDRESS ……………………………………………………………………………………………..

WORK

PLACE/ADDRESS………………………………………………………………………………………………

……………………………………………………………………………………….PHONE …………………….

OCCUPATION …………………………………………………………………………………………………..

I am happy for this person to be an emergency contact YES/NO

In an emergency we would try to contact parent/carers at home or work. If no-one is

available from the contacts above, is there a friend/relative who we could contact?

Please fill out two contacts if possible.

EMERGENCY CONTACT

NAME MR/MRS/MISS/MS ……………………………………………………………………………….

DAYTIME PHONE NO ……………………………………………………………………………………….

In the event of an emergency, please list order of contact:-

1. ………………………………………………………………………………………………………………

2. ………………………………………………………………………………………………………………

3. ……………………………………………………………………………………………………………… 4. ………………………………………………………………………………………………………………

EMERGENCY CONSENT

□ Giving this consent enables the school to act on behalf of the parent/carer in

the event of an emergency

□ Artificial colouring allergy □ Gluten free

□ No dairy produce □ No nuts of any type/quantity

□ Other – please give details …………………………………………………………….

Any other contact

Special Dietary Needs

Home/First Language

English □ Punjabi □

Other Language – please state:- …………………………………………………………….

Second Language used at home

English □ Punjabi □

Other Language – please state:- …………………………………………………………….

Country of Birth:- ………………….……………………………………………………………

Nationality:- …………………….…………………………………………………………………

Religion

Sikh □ No Religion □

Christian □ Buddhist □

Hindu □ Refused □

Jewish □ Roman Catholic □

Muslim □ Other Religion – please state:- ……………………..

Ethnicity

Please read the following notes carefully. Accurate information helps the school to

support all students in achieving their potential.

Our ethnic background describes how we think of ourselves. This may be based on

many things including language, culture, ancestry or family history. Ethnic

background is not the same as nationality or country of birth.

GENERAL

The Information Commissioner (formerly the Data Protection Registrar)

recommends that young people aged over 11 years old have the opportunity to decide their own ethnic identity. Parents or those with parental responsibility are asked to

support or advise those children aged over 11 in making this decision, wherever

necessary. Pupils aged 16 or over can make this decision for themselves.

Please tick one box from the list below and tick if the form was filed out by the

parent.

Any other Asian Background □ Chinese □

Any other Black Background □ Gypsy Roma □

Any other Ethnic Background □ Indian □

Any other Mixed Background □ Pakistani □

Any other White Background □ Traveller of Irish Heritage □

Black African □ White & Black African □

Black Caribbean □ White & Black Caribbean □

Bangladeshi □ White British □

White Irish □ White & Asian □

I do not wish an ethnic background category to be recorded □

This information was provided by:- Parent □ Pupil □

Asylum Status:-

Asylum seeker □ Refugee □ Not Applicable □

Meal Arrangements

Free School Meal □ School Meal □ Packed Lunch □

Travel to School

Please tick the normal daily method of travel

Travel Plan □ Car □ Taxi □

Walk □ Bicycle □ Bus □

Service Children in Education YES/NO

In Care Details

Start Date ………………………………….. Young Carer ………………………………….

End Date …………………………………….

Care Authority …………………………… Disabilities ……………………………………

Relationship and Sex Education

As recommended by Coventry City Council, we deliver the core package for

relationships and sex education to all secondary year groups. This is in line with

lessons being delivered across the city. If you do not wish your child to participate in

these lessons, please inform us in writing.

Collective Worship and RE

All children will participate in Collective Worship and RE. If you do not wish your

child to participate in these, please inform us in writing.

The Head Master reserves the right to rule on what is appropriate to wear to school.

The Head Master’s decision is final.

We are very proud of the high level of expectation at Seva; students will succeed and achieve by demonstrating an exemplary attitude towards their behaviour and learning.

Name of Child:-

……………………………………………………………………………..………………….……….

Form Class:-

.………………………………………………………….…………………….……..………………..

Name of Family Doctor:- …………………………………..…………….…………………..

Phone number:- ………………………………………

Doctor’s Address:-

………………………………………………………………………………………………………………

………………………………………………………………………………………………………………

………………………………………………………………………………………………………………

Does your child suffer from any of the following? If yes, please tick which one

applies to you.

Asthma Diabetes

Epilepsy Allergies

If yes, please give details including any medication required:- ……………………...

………………………………………………………………………………………………………………………….

Does your child have a health care plan?

Yes No

If your child is suffering from asthma:-

We would prefer that the school is provided with an extra inhaler as a

backup

An additional consent form for the administration of emergency

Salbutamol inhaler needs to be completed

Medical Information Form

tel:-

Does your child have any other medical conditions we should be aware of, for

example, migraines, eczema?

Yes No

If yes, please give details:-

………………………………………………………………………………………………………

Parental signature …………………………………………………………………………..

Date …………………………………………..

Please complete all sections and return to the school office as soon as possible.

Name of Child:- …………………………………………………………………..

Form:- …………………………………………………………………………………

DOB:- ………………………………………………………………………………….

I consent to my son/daughter receiving the following medication/treatment if thought

appropriate by the designated First Aider. (Please tick appropriate box).

The provision of Hypoallergenic plasters Yes No

Cold compress Yes No

I undertake to notify the school in writing, should I decide to withdraw my consent.

Name of Parent/Guardian:- …………………………………………………………………………………

Medical Consent Form

Signature of Parent/Guardian:- …………………………………………………………………………..

Date:-

…………………………………………………………………………………………………………………

Please complete all sections and return to the school office as soon as possible.

Pupil Name: Class:

Parent Name:

Signature:

Date:

Please complete all sections in capital letters and return to the school office as soon as possible.

USE OF PHOTOS TICK CONSENT

(YES)

TICK DO NOT CONSENT

(NO)

I am happy for the school to take photos of my child.

I am happy for photos of my child to be used on the school website.

I am happy for photos of my child to be used in the school newsletter.

I am happy for photos of my child to be used in printed school materials, for example, the school prospectus.

I am happy for photos of my child to be used in internal displays.

I am happy for photos of my child to be used in the media, for example local newspapers.

I am happy for photos of my child to be used on social media, for example Twitter.

I am happy for the school to take videos of my child.

I am happy for the school to use videos of my child for promotional purposes, such as on the school website.

I am happy for my child to have a class photo

I am NOT happy for the school to take or use photos or videos of my child.

I am happy for my child to have a Biometric Fingerprint

Image Consent Form

IMPORTANT - Arrangements in the event of un-planned School Closure

If we are faced with having to close the school we need to be as prepared as possible

and therefore ask for your assistance by selecting one of the options below;

For pupils who use school transport:

Send my child on the school bus (we will have arrangements in place on their

arrival)

Please keep my child in school until I can collect them, or the named person below can collect them

For pupils who walk home or are collected:

Allow my child to walk home (we will have arrangements in place on their

arrival)

Please keep my child in school until I can collect them, or the named person

below can collect them

Other Named contacts who can transport my child:

...................................................................................................................................

……………………………………………………………………………………………………………………

Please complete all sections and return to the school office as soon as possible

School Closure Arrangements

Collection of Children Authorisation Form

The following will be authorised to collect my child from Reception.

Name of Child:-

_________________________________________________________

Year Group:-

_________________________________________________________

1. Name:-

_____________________________________________________

Relationship to child:- _____________________________________________

2. Name:-

_____________________________________________________

Relationship to child:-

______________________________________________

3. Name:-

_____________________________________________________


_____________________________________________

4. Name:-

_____________________________________________________


_____________________________________________

5. Name:-

_____________________________________________________


_____________________________________________

I consent for my child to partake in any school organised event other than any

residential activity within a 50 mile radius.

Name of Child: ....................................................

Year Group/Class…………………………………………

Parental Consent:

Name: ........................................ Sign: ...............................................

Medical information – please advise if there are any medical conditions to be

considered when planning trips/activities for your child.

Any Medical Conditions: ……………………………………………………………

Diagnosed: ……………………………

Other Medical Condition: …………………………………………………………

Diagnosed: ……………...……………

Other Medical Condition: …………………………………………………………

Diagnosed: ……………...………………

Medication Requirements:

…………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………

Consent form for school trips and other off-site activities whilst at Seva

School.

By signing the consent form above you consent for your child to take part in

organised school trips and other activities that take place off school premises within

a 50 mile radius during their time with us.

Off-Site Visit Consent School Copy

Details of each activity will be sent to you allowing time for you to notify us should

you prefer for your child not to take part in the visit.

Please consider the following important information before signing this

form:

The trips and activities covered by this consent include; o all visits within a 50 mile radius o adventure activities at any time o off-site sporting fixtures outside the school day

The school will send you information about each trip or activity before it takes place and should you prefer for your child NOT to join that activity you must contact the school office at least 5 days prior to the trip/activity date

Please note additional written consent WILL be requested for any residential trips.

Please keep the guidance above for your own records.

Off-Site Consent Parent Copy

Dear Parent/Carer

To assist our school systems, may we please request that you complete a number of

documents and return them to us. Please be assured that in line with the Data

Protection Act 1998, the information that you share will be under restricted access and

is subject to the provisions of the Data Protection Act 1998. The information will be

disclosed only to the Education Authority, Health and Welfare Agencies, where law or

an emergency necessitates a disclosure.

Information for you to complete and return to us include:-

Medical Information Form

Medical Consent Form

Image Consent Form

Off-Site Visit Consent Form

Collection of Children Authorisation Form

School Closure Arrangements

Home School Agreement

Please return your completed forms to the class teacher either by hand or by post.

Should you require any further assistance, please do not hesitate to contact any of our

friendly office team who are happy to help.

Yours faithfully

Miss R Saggu

Head Teacher

Seva School, Link House, Eden Road, Walsgrave Triangle, Coventry, CV2 2TB. Tel: 024 7798 7619

Dear Parent/Carer

Re:- Your Child’s Current School

We would like to ask your current child’s school to release your child’s personal

information to Seva School in order that we may ensure a high quality provision for

your child in September. Please complete the slip below and either hand it in to your

child’s school or give it to Seva staff who will send it for you.

Yours faithfully

Ms R Saggu

Head Teacher

I (Parent Name) --------------------------------------------------------------------------------

Parent of (Child’s Name) ----------------------------------------------------------------------

Parent Address ----------------------------------------------------------------------------------

Authorise (School Name) ----------------------------------------------------------------------

To release all documentation and information regarding my child to Seva School.

Records of Achievement

Progress Data especially that which has been submitted either to the Local

Authority or the DfE, such as EYFS Assessments, Phonics for Year 1/Year 2 and

Year 6 SATS.

My child’s UPN

Any other information that will help us to ensure that a high quality provision

can be structured for my child in September

I understand that Seva School will make contact with you over the next few weeks to

arrange the collection or delivery of this information.

Seva School, Link House, Eden Road, Walsgrave Triangle, Coventry, CV2 2TB, Tel: 024 7798 7619

s Service, excellence, virtues and aspiration…

seva school, coventry, west midlands admission form name:-...

Documents